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Dry scalp eczema: Symptoms, treatment, and natural remedies

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Get the latest on managing your symptoms, treatment options and living with Eczema.

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Mindfulness and self-compassion training can improve quality of life and symptoms for people living with eczema, according to a new study.

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Scalp eczema is a type of eczema that causes inflamed, itchy, dry skin to form on the scalp. The most common type of scalp eczema is known as seborrheic dermatitis, and its most unwelcome symptom is dandruff.

By Joseph Bennington-CastroApril 03, 2023

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Symptoms, treatment, and natural remedies

Eczema can result in inflamed, dry, itchy skin. On the scalp, skin may appear scaly and red, or a lighter color than the surrounding skin. A person may also experience dandruff.

One of the main types of eczema that can affect the scalp is seborrheic dermatitis. It appears in areas where the skin is most oily, such as the scalp, face, and upper back. When seborrheic dermatitis affects babies, it is known as cradle cap.

In this article, we look at risk factors for scalp eczema, how to prevent it, and what treatment involves.

Seborrheic dermatitis is a type of eczema linked with the scalp, though it can appear in other areas with a lot of oil-producing glands in the skin.

Doctors do not fully understand what causes seborrheic dermatitis, but a type of yeast that lives on the skin may be involved. Malassezia, this yeast, exists on everyone’s skin, and it may trigger an immune response in some people. This response leads to the inflammation and itchiness.

Seborrheic dermatitis affects up to 5% of the general population, and slightly more males than females have it. It is common in babies. In adults, it is most common in people aged 40 or over.

Seborrheic dermatitis can resemble dandruff, which is a milder condition that affects up to half of the population.

It is possible for other types of eczema to affect the scalp, including atopic eczema or contact dermatitis. A doctor, such as a dermatologist, can identify the type.

Certain factors can make people more prone to seborrheic dermatitis. These include:

  • having oily skin
  • being male
  • living in a dry or cold environment
  • having a condition that weakens the immune system, such as HIV
  • having a neurological condition, such as Parkinson’s disease
  • having certain mental health conditions, such as depression or an eating disorder
  • taking certain medications, such as lithium, dopamine antagonists, or immunosuppressants

The following might trigger a flare-up of this type of eczema:

  • stress
  • lack of sleep
  • sweating
  • irritants
  • dry skin

People can usually tell the difference between eczema and dandruff by looking for visible signs of inflammation. Both eczema and dandruff can cause flaky skin and itchiness, but only eczema typically causes inflamed patches of skin.

Researchers think that dandruff and seborrheic dermatitis are part of the same disease process and that both are related to the presence of Malassezia fungus on the scalp.

Research from 2015 argues that the two exist on a continuum, with dandruff is on the milder end and seborrheic dermatitis causing more severe symptoms.

Scalp eczema causes patches of itchy, inflamed, dry skin. The patches may change in shape and size over time.

People with seborrheic dermatitis may also have:

  • patches of waxy or oily skin
  • skin that flakes off
  • yellow or red discoloration, in people with lighter skin tones
  • skin that is darker or lighter than the surrounding area, in people with deeper skin tones

The condition typically appears in areas with a lot of oil-producing glands. A person with seborrheic dermatitis on their scalp may also have it in other areas that produce oil, such as the:

  • nose
  • eyelids
  • eyebrows
  • ear canal
  • area behind the ears
  • upper back

Even after the rash heals, any color changes may last.

The best approach depends on the type of eczema a person has. For seborrheic dermatitis, treatment involves using topical products that reduce the growth of the yeast, calm inflammation, and remove the flakiness.

The first step involves skin care, and a dermatologist can describe how to keep the scalp clean and hydrated. Replacing any harsh shampoos with gentle, pH-balanced ones may reduce irritation, for example.

Next, the doctor may recommend an antifungal cream, spray, or scalp treatment. This may contain a combination of:

  • zinc pyrithione
  • salicylic acid
  • selenium sulfide
  • ketoconazole
  • ciclopirox
  • sulfacetamide
  • coal tar
  • sulfur

For more severe cases, a mild corticosteroid can calm the inflammation. A doctor may prescribe a topical corticosteroid, which goes on the skin, to treat an active flare-up that causes severe pain, itching, and flaking. Corticosteroids are not suitable for use over long periods, however.

A doctor may also prescribe a topical medication that suppresses the immune system. These products do not contain corticosteroids and a person can use them for longer periods. For very severe cases, doctors may prescribe an oral antifungal medication.

For babies with cradle cap, mineral oil can help loosen the flakes so that they fall off with gentle washing. Usually, this is all that is necessary. The condition often improves on its own after a few months.

In adults, seborrheic dermatitis can come and go for long periods and require managing to reduce flare-ups.

Many prescription products for seborrheic dermatitis contain ingredients that people can purchase over the counter, such as:

  • coal tar, which reduces itching
  • sulfur, an antibacterial mineral
  • salicylic acid, a compound that naturally occurs in plants and exfoliates flaky skin

Many over-the-counter scalp treatments contain these substances.

Also, some research shows that daily use of a 5% tea tree oil shampoo can significantly improve mild-to-moderate symptoms without causing side effects. However, less research has gone into this approach.

People should never use essential oils undiluted on the skin. Also do not use these oils at all to treat eczema in children or babies.

There is no single test for scalp eczema. The yeasts that play a role in seborrheic dermatitis occur naturally on everyone’s scalp, so testing for these will not help.

Instead, a doctor does a physical examination and takes the person’s medical history. They may diagnose eczema based on the symptoms alone, or they may perform tests to rule out other possibilities, such as an allergic reaction.

The specific symptoms can also reveal the type of eczema.

If a doctor suspects a fungal infection, they may take a skin scraping and send it for analysis.

Since experts are not sure exactly why scalp eczema develops, they cannot recommend a surefire method of prevention.

Still, a person can reduce the chances of the condition flaring up by:

  • avoiding contact with harsh soaps, chemicals, or solvents
  • protecting the head in cold or dry weather
  • using a humidifier to make indoor air less dry
  • washing the scalp after exercise and other activities that cause sweating
  • reducing and managing stress levels
  • receiving treatment for any medical conditions that increase the risk of seborrheic dermatitis

If a medication may be contributing to scalp eczema, a doctor can describe the next steps.

Seborrheic dermatitis is a type of eczema that tends to affect the scalp. Doctors believe that it results from an immune system reaction to a type of yeast that naturally grows on the skin. Seborrheic dermatitis causes one or more patches of itchy, flaky skin, which may feel oily.

Treatment may involve using topical creams, sprays, or shampoos that contain antifungal and anti-inflammatory ingredients.

Because other types of eczema can also occur on the scalp, it is important to get a diagnosis. The doctor can also rule out other conditions that can cause an inflamed or flaky rash, such as psoriasis.

Read the article in Spanish.

Treatment of eczema

Eczema is a chronic inflammatory skin disease of an allergic nature, the etiology and pathogenesis of the disease is not fully understood, but the presence of eczema in close relatives, a history of allergic diseases, exposure to endogenous and exogenous factors in the causes of the appearance of a small-bubble eczema rash are out in first place. Psychovegetative, neuroendocrine and immunological disorders can provoke eczema. A neglected course can lead to neurosis: insomnia, irritability, as well as persistent cosmetic skin defects. Treatment for eczema depends on its form and course.

  • True eczema
  • Microbial eczema
  • Seborrheic eczema
  • Occupational eczema
  • Principles for the treatment of eczema

True eczema

True eczema has a chronic course with frequent relapses and is manifested by symmetrical areas of inflammation on exposed skin. With true eczema, the foci of inflammation are hyperemic, edematous, weeping of the surface is noted. Groups of small vesicles with serous contents are found within the focus. After the vesicles break open, they leave microerosions typical of eczema.

On the periphery of the focus of eczema, single larger rashes and vesicles are observed. Over time, the number of newly emerging bubbles decreases and microerosion shrinks into crusts, after healing of which a scaly bran-like surface remains.

Most patients with eczema complain of pruritus. In addition to the main lesions, there may be scattered rashes on various parts of the skin, but without weeping. Patients with long-diagnosed eczema note congestive skin hyperemia, infiltration and hyperpigmentation after relief of exacerbations, over time, the skin pattern becomes pronounced.

Microbial eczema

Lesions in microbial eczema are asymmetrical and located mainly on the lower extremities, the favorite localization is the projection of the skin affected by varicose veins. The appearance of foci of microbial eczema in the folds of the skin is associated with sweating and violation of personal hygiene. The borders of eczematous spots are uneven, the adjacent skin is infiltrated, has a bluish-red tint. Weeping and purulent crusts are present in all affected areas, along the periphery there are single papules and papulovesicles. Microbial eczema is divided into mycotic, varicose and paratraumatic.

The diagnosis is made on the basis of clinical manifestations, the presence of mycoses in the anamnesis of the patient, varicose veins of the lower extremities and frequent injuries. With microscopy, it is possible to detect mycotic cells, bacteriological examination is used to identify the exact type of mycosis and to determine sensitivity to drugs.

Seborrheic eczema

A feature of seborrheic eczema is the appearance of lesions on the scalp, in addition, the foci are located in natural skin folds, on the face, around the navel, behind the ears and on the flexor surfaces. On the scalp in the inflamed areas, hyperemia, dry skin and itching are noted, gray scaly scales are separated when combing. The boundaries of lesions have clear outlines. If the foci occur in places of natural folds, then deep painful cracks, pronounced edema and infiltration can be seen on their bottom, and small grayish-yellow scales and scaly crusts along the periphery of the foci.

Occupational eczema

Occupational eczema is a long-term, indolent chronic skin disease of an allergic nature that occurs in response to constant contact with irritating substances. Occupational eczema is based on constant exposure to industrial factors (dust, chemical aggression, dry or humid air, frequent microtraumas, etc.), disorders of the autonomic nervous system, permeability disorders and vascular fragility. As a result of a combination of these factors, the body develops sensitization to occupational hazards.

Clinically, occupational eczema is similar to true eczema, but the provoking factor is constant contact with an irritant. When questioning the patient, it turns out that there are harmful factors at work or at home, and the manifestations intensify after direct direct contact with the irritant, and each subsequent contact increases the symptoms of eczema. During the absence of exposure to occupational hazards, such as on vacation, the skin looks clinically healthy.

Eczema principles

After a confirmed diagnosis of eczema, it is necessary to eliminate or reduce the influence of provoking factors: neuropsychic overload, medication, contact with allergens and aggressive substances, treat fungal infections and microbial skin diseases.

Hyposensitizing drug treatment using sedatives and antihistamines is indicated for any type of eczema, detoxification therapy also has a positive effect on the patient’s condition. Vitamin therapy, both internal and local, activates the process of cell regeneration.

If the exacerbation of eczema is acute, is of a generalized nature, or if it is not possible to stop the relapse with conventional therapy, then the use of glucocorticosteroids intravenously and the place in the minimum effective dose is indicated, after the condition improves, the dose of hormones is gradually reduced.

Topically applied applications with ointments and pastes that have keratolytic properties, have an antipruritic effect and contain anti-inflammatory and antiseptic components. Local therapy of eczema with still unopened vesicles consists in applying neutral ointments, talkers and powders. The composition of the drug for local treatment is selected individually and is prescribed by a dermatovenereologist. Treatment of affected areas with water, vegetable oil and aggressive disinfectant solutions is strictly prohibited. Affected areas should be protected from frost, wind, exposure to solar radiation.

Numerous physiotherapy treatments for eczema. These include: ozone therapy, magnetotherapy, cryotherapy of eczema-affected skin areas. Persons who have been diagnosed with eczema should follow a hypoallergenic diet, give up alcohol and smoking. Great importance should be given to personal hygiene, the use of unscented soaps and water-based creams can reduce the risk of recurrence of eczema.

Eczema, its types and causes. Eczema Treatment

Eczema is a polymorphic relapsing skin disease. It can be acute or chronic in form. This disease is characterized by the appearance of bubbles of various shapes and sizes, skin irritation, peeling, itching. Eczema can occur in a person of any age and accounts for about 40 percent of all skin diseases.

What can cause eczema?

Eczema can appear anywhere on the body, but it most commonly affects the face, neck, décolleté, elbows, wrists and ankles. Symptoms of eczema: dry skin, with peeling on the surface, cracks and crusts.

There are many causes of eczema, the disease can develop due to internal and external factors. Among external factors:

  • physical damage: cuts, injuries,
  • chemical damage: allergies to various chemicals, bacterial allergies.

Among internal factors:

  • metabolic disorders,
  • allergies, hormonal problems,
  • diseases of the nervous system and internal organs,
  • genetic predisposition.

Varieties of eczema

Specialists distinguish several types of eczema, divided depending on the cause and localization.

  • idiopathic or true eczema. This is an inflammatory disease characterized by multiple variegated rashes, most often on the palms and soles of the feet. Bubbles open with the formation of weeping areas, crusts and scales, itching begins. As new blisters continue to appear, the lesion grows in size, trapping skin on other parts of the body.
  • with microbial eczema, the skin of the legs, the back of the hands and the scalp are usually affected. The causative agent of the disease is a yeast pyococcal fungus, a person develops greenish-yellow rashes, serous-purulent crusts and erosion. With an exacerbation, bleeding of the affected areas may appear and itching intensifies.
  • with occupational eczema, exposed areas of the body are affected by chemical reagents, it occurs in people working in industries, if they have allergic dermatitis.
  • children may experience childhood eczema associated with heredity or exacerbation of diathesis. The disease is localized on the face, on the scalp, gradually spreading and increasing in size. Abundant red rashes, peeling appear on the child’s skin, he is worried about burning, itching.
  • with seborrheic eczema, the skin on the head, chest, in the interscapular region is affected. This type of eczema is characterized by yellowish-pink rashes, an abundance of yellowish layered crusts, scales.

The disease is long-term, it can subside or worsen without any obvious reasons.

Diagnosis and treatment of eczema in the clinic “Doctor”

During the initial consultation, our specialist dermatologist carefully collects an anamnesis. The doctor will help to deal with the possible causes of the disease, conducts differential diagnostics (scrapings, samples, etc.). Effective treatment of the disease requires the elimination of irritants that led to its appearance. The results of the research become the basis for the preparation of a treatment program.

The treatment program includes both symptomatic and etiotropic treatment. Immunomodulators and vitamins increase the body’s resistance, itching and an allergic condition are eliminated by antihistamines.